Postoperative outcome and influencing factors of strabismus surgery in infants aged 1-6 years

Purpose: To evaluate the postoperative outcome of strabismus surgery performed in children aged 1-6 years by investigating the change of the preoperative angle of deviation (AOD), elevation in adduction, best-corrected visual acuity (BCVA) and refractive error. Methods: Retrospective chart review of 62 children who received strabismus surgery between January 2018 and December 2021 at the Department of Ophthalmology and Optometry of the Medical University of Vienna. Age, sex, type of strabismus, AOD, BCVA, refractive error and visual acuity were evaluated with respect to the postoperative outcome. Results: Mean follow-up was 13.55 +/- 11.38 months with a mean age of 3.94 +/- 1.97 years (range: 1.0-6.0) at time of surgery. 74.19% of patients (n = 46) had isolated or combined esotropia, 12.90% (n = 8) had isolated or combined exotropia and 12.90% (n = 8) had isolated strabismus sursoadductorius. Mean preoperative AOD of 15.69 +/- 16.91 degrees/15.02 +/- 14.88 degrees (near/distance) decreased to 4.00 +/- 9.18 degrees/4.83 +/- 7.32 degrees (near/distance) at final follow-up (p < 0.001). BCVA improved from 0.26 +/- 0.26/0.25 +/- 0.23 (left/right) to 0.21 +/- 0.25/0.20 +/- 0.23 (left/right) (p = 0.038). There was no significant change regarding refractive error (p = 0.109) or elevation in adduction (p = 0.212). Success rate which was defined as a residual AOD of less than 10 degrees was 74.19% (n = 46). In 3.23% (n = 2) retreatment was necessary. Conclusion: Strabismus surgery in infants was shown to have a satisfactory outcome with a low retreatment rate. Surgical success rate was not linked to age, sex, type of strabismus or the preoperative parameters AOD, refractive error and visual acuity in this study.